Gonadotropin-releasing hormone analogue plus hormone replacement therapy for the treatment of endometriosis: a randomized controlled trial.
OBJECTIVE
The aim of this study was to determine whether or not continuous combined HRT used with GnRH-a for the treatment of endometriosis can prevent hypoestrogenic side effects associated with GnRH-a.


METHODS
Forty premenopausal women with laparoscopically proven endometriosis entered the study. The patients were randomized into two groups. Group I (n = 19) received 3.75 mg i.m. leuprolide acetate (LA) every 4 weeks for 24 weeks. Group II (n = 21) received 3.7 mg LA combined with 1.25 mg oral conjugated equine estrogen (CEE) and 5 mg oral medroxyprogesterone acetate (MA).


RESULTS
Total revised AFS score as well as total pelvic pain scores decreased significantly (P < .001) in both groups. However, a statistically significant difference of hot flushes and sweating was reported by women receiving LA + HRT as compared to those treated with LA alone (P < .001). Furthermore, the bone loss at the lumbar spine was 4.2% in group I compared to 0.9% in group II at the end of the study.


CONCLUSIONS
This study suggests that 1.25 mg CEE + 5 mg MA is effective in preventing hypoestrogenic side effects caused by GnRH-a, while the treatment of endometriosis is not impaired.
Gregoriou
O
O
2nd Department of Obstetrics and Gynecology, University of Athens, Areteion Hospital, Greece.
Konidaris
S
S
Vitoratos
N
N
Papadias
C
C
Papoulias
I
I
Chryssicopoulos
A
A
D000328:Adult; D015519:Bone Density / Q000187:drug effects* / Q000502:physiology; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D004715:Endometriosis / Q000097:blood / Q000188:drug therapy*; D004958:Estradiol / Q000097:blood / Q000378:metabolism; D015914:Estrogen Replacement Therapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood / Q000378:metabolism; D019584:Hot Flashes / Q000139:chemically induced; D006801:Humans; D007273:Injections, Intramuscular; D016729:Leuprolide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007986:Luteinizing Hormone / Q000097:blood / Q000187:drug effects / Q000378:metabolism; D015663:Osteoporosis, Postmenopausal / Q000139:chemically induced*; D017699:Pelvic Pain / Q000188:drug therapy; D011446:Prospective Studies; D013546:Sweating / Q000187:drug effects; D013997:Time Factors
D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D016729:Leuprolide